1.The prevalence and several clinical characteristics of myotonic dystrophy in the population of Mongolia
Baasan D ; Erdenechimeg Y ; Oyungerel B ; Sarantsetseg T ; Khandsuren B ; Chimeglham B
Mongolian Medical Sciences 2011;168(1):23-26
Backgroundв Previous the prevalence of myotonic dystrophy was identified very rare, because of the poor diagnostics. In fact, due to getting high quality of diagnostical equipments the disease is determined very common among people in the world. According to some researchers’s statistical data during 1980-1990 years, the prevalence was 1.1 in England, 2.4 in South Ireland, 5.0 in Switzerland per 100.000 population.Goal. The study was aimed to establish the prevalence of myotonic dystrophy in MongoliaMethod. In this study which is a part of a general epidemiological study of some hereditary neurological diseases in Mongolia since 1997, authors established the prevalence of myotonic dystrophy among 1.7 million population from 14 aimags and the capital city Ulaanbaatar during the period from 1997 to 2010.Results. The prevalence by aimags was ranged from 0.0 to 27.06 per 100.000 population. The average nationwide prevalence is 5.63 per 100.000. Several aimags, especially Gobi-Altai, Orkhon and Khuvsgul are high prevalence with over 3-5 times the average. But in Dornod, Bayan-Ulgii, Dundgobi, Zavkhan, Uvurkhangai, Khentii aimags didn’t have a case of myotonic dystrophy in their population. The rest of aimags have a prevalence from 2.45 (Uvs) to 5.0 (Ulaanbaatar) per 100.000 population.Conclusion1. The relatively high prevalence of myotonic dystrophy was determined among the Mongolian population, especially in Gobi-Altai, Orkhon and Khuvsgul aimags with over 3-5 times the average. 2. The disease is spreading through reproductive way in some isolated populations. There is also a trend of increasing incidence of the disease in urban areas apparently through mechanic way rural to urban migration. 3. The study concludes that there is a need of more intensive response to fight and prevent this disease through upgrading to the modern neurological and genetic diagnostics of the disease, and their regular and sustainable application. Consequently, there is also should be need to create and improve clinical and genetic counseling for patients with this disease.
2.The prevalence of hereditary spastic paraplegia in population of Mongolia
Baasanjav D ; Erdenechimeg Y ; Oyungerel B ; Sarantsetseg T ; Khandsuren B ; Chimeglham B
Mongolian Medical Sciences 2011;168(1):27-30
Background. The prevalence of hereditary spastic paraplegia or Shtrumpel disease is very various in studied countries of the world. It fluctuated between 0.43 (Bulgaria) and 72.4 (South African Republic) per 100’000 population.Method. In this study which is a part of a general epidemiological study of some hereditary neurological diseases in Mongolia since 1997, authors established the prevalence of myotonic dystrophy among 1.7 million population from 14 aimags and the capital city Ulaanbaatar during the period from 1997 to 2010.Goal. The study aimed to establish the prevalence of hereditary spastic paraplegia (HSP) in Mongolia.Material and Method. This study is part of a general study of the epidemiology of hereditary neurological diseases in population of 14 aimags (provinces) and the capital city Ulaanbaatar (the total population covered by the study was 1’738’000) which is being carried out since 1997. The sizes of population in aimags and the city ranged from 47,800 (Southgobi) to 605,292 (Ulaanbaatar). This study report extrapolates the prevalence nationwide. Diagnosis was established by mainly clinical characteristicsResult. Study revealed 47 patients from 15 families. The prevalence of HSP by aimags was established from 0 to 13.48 per 100’000 population (Uvs aimag). The average nationwide prevalence (1’700’000 above) was established at 2.70/100’000. There are revealed 9 cases (19.1%) in ages of 0 and 14, 6 cases (12.8%) in ages of 14-19, 27 cases (57.5%) in ages of 20- 49 and 5 cases (10.6%) in age above 50.Conclusion1. By prevalence of HSP Mongolia belongs to countries with average prevalence. But the prevalence rates differ by aimags. Patients with HSP in Ulaanbaatar (11 cases) were covered by molecule-genetic analysis by types of the disease, revealing occurrences of II and IV subtypes. 2. Of all patients, 90% are below 50 years of age pointing to the early morbidity with this disease in the context of their early mortality. The situation reveals the need of further moleculegenetic and clinical studies of the types of this disease and of improvement of clinical and genetic counseling of HSP patients.
3.Structure and prevalence of hereditary neurological diseases in population of some provinces (aimags) of Mongolia
Baasanjav D ; Erdenechimeg YA ; Oyungerel B ; Sarantsetseg T ; Chimeglkham B ; Khandsuren B
Mongolian Medical Sciences 2010;152(2):24-30
BACKGROUND: The study of epidemiology of hereditary neurological diseases in Mongolia began a few years ago. Itcovered a few aimags (provinces) (D.Baasanjav, 2000-2005). Previous studies have shown, that hereditary neurologicaldiseases are not rare in Mongolia and structure and prevalence of these diseases vary by aimags. Mo n g o l i ahas 21 aimags (administrative provinces), each with a population from 45000 till 110440. In some “isolated” populationsspecific neurological hereditary diseases can be marked as “indigenous”. So the epidemiological study of hereditaryneurological diseases in Mongolia is one of the urgent medical shortcoming in Mongolia.MATERIAL AND METHOD: We used descriptive epidemiological method for revealing hereditary neurological diseases infamilies in population of 8 provinces (aimags) of Mongolia, Bayan-Ulgii, Bayankhongor, Govi-Altai, Zavkhan, Dundgobi,Khentii, Orkhon, Uvurkhangai, total of 627,000 population. The population of these aimags fluctuated in the range from47959 (Dundgobi) to 110440 (Uvurkhangai). Diseases were diagnosed by neurologists using clinical and genealogicalmethods.RESULTS: The study revealed 77 patients in 40 families in the studied population with variety of neurological hereditarydiseases. The overall prevalence of hereditary neurological diseases for 100,000 population is 12,26. The prevalencevaries by aimags from 2,08 (Dundgobi) to 32,50 (Gobi-Altai) per 100.000 population. The prevalence and their rangeby nosological structure per 100000 population in aimags are: myotonic dystrophy 5.41 widely varying by aimags: from4.66 in Bayankhongor to 27.09 in Gobi-Altai; Charcot-Marie-Tooth syndrome 1.59 and ranging from 2.08 in Dundgobito 4.66 in Bayankhongor; Duchenne muscular dystrophy -0.79 and ranging from 0.90 in Uvurkhangai to 3.19 in Bayan-Ulgii; the limb girdle muscular dystrophy -0.95 and ranging from 1.81 in Uvurkhangai to 4.66 in Bayan-Ulgii; Strumpellfamilial spastic paraplegia -0.95 for total pop and ranging from 2.71 in Uvurkhangai to 5.41 in Bayankhongor; familialparoxysmal myoplegia -0.79 for total pop. and range from 2.22 in Orkhon to 5.41 in Gobi-Altai; spinocerebellar ataxia -0.47 for total pop. (3.91-in Zavkhan); bulbo-spinal amyotrophy -0.32(only in Bayankhongor); spinal amyotrophy of adults-0.16(only in Uvurkhangai); arthrogryposis with myodystrophy -0.63 (only in Khentii); kyphoscoliosis with myodistrophyand nanism -0.16 (1.06 in Bayan-Ulgii)A comparatively high prevalence of all neurological hereditary diseases per 100.000 pop. was established in Gobi-Altai(32.50), Orkhon-26.56, Bayankhongor-15.16, Bayan-Ulgii -11.70 rates; the low prevalence - in Dundgobi-2.08 and-Zavkhan-3.91.The hereditary neuromuscular diseases among all hereditary neurological diseases taken up 71.9% i.e 55 patients from29 families. The myotonic dystrophy is tops the list of neuromuscular diseases (61.8%)CONCLUSION: Hereditary neurological diseases have a relatively high prevalence among the population of Mongolia,specially the neuromuscular diseases; so the control of these diseases in the country is one of the special priorityproblem of the national health care.
4.Prevalence and clinical characteristic of multiple sclerosis in rural population of Mongolia
Baasanjav D ; Erdenechimeg YA ; Oyungerel B ; Sarantsetseg T ; Chimeglkham B ; Khandsuren B
Mongolian Medical Sciences 2010;152(2):31-36
BACKGROUND: Multiple sclerosis is spreading in population of Mongolia last 30 years. But there are rare of the date ofprevalence of this disease in Mongolia. So we have studied the prevalence of this disease in population of 8 provinces(aimags) of Mongolia in 2008 year.GOAL: To reveal and establish prevalence and clinical characteristic of multiple sclerosis (MS) in population of 8 aimags(provinces) of Mongolia.METHOD: Revealing of patients with multiple sclerosis in population was made by neurologists, which are possessedof clinical method for revealing or confirm the diagnosis and were taken in register the patients only with confirmeddiagnosis. This study was conducted in following 8 aimags of Mongolia: Bayan-Ulgii, Bayankhongor, Gobi-Altai,Dundgobi, Uvurkhangai, Zavkhan, Khentii, and Orkhon; total population of these aimags is 627762 (m-306482, f-321279). The prevalence of this disease was calculated for 100.000 populations.RESULTS: There have been revealed total 35 patients in 8 aimags. The prevalence for 100.000 population is 5,57 (m-2,61; f-8,40) and has been fluctuated in provinces in range from 1,81 (Uvurkhangai aimag) till 13,28 (Khentii aimag) for100 000 population.The rest 6 provinces (aimags) have prevalence in range from 4,17 (Dundgobi) till 6,38 (Bayan-Ulgii).All patients were distributed by clinical characteristic in next main forms:Cerebro-spinal form in 22 patients (62,8%) among them optico-myelitis in 9 cases (40,9%); Spinal form in 6 patients(17,1%); Cerebral form in 4 cases (11,4%); only optical form in 3 cases (8,6%).Pure spinal, cerebral and optic forms are diagnosed in patients, which have duration of disease no more 6-7 years.By the courses of disease all patients distributed in courses the beginning with acute attack incomplete recovery(remissions) revealed in 18 patients (51,4%), more rapid but steadily progressive course in 5 cases (14,3%), acutesevere attacks course in 5 patients (14,3%).CONCLUSION:1. Multiple sclerosis is spreading in population of Mongolia in last 30 years after 1980.2. The prevalence of this disease in population of 8 provinces (aimags) of Mongolia in 2008 year is 5,57 cases (inmen-2,61; in women-8,40) for 100.000 population. The rates of prevalence of the disease by aimags are oscillated inrates from 1,81(Uvurkhangai) till 13,28 (Khentii) for 100.000 population.3. The women suffered more in 3 time than in man and optic form revealed in 34,2 % cases (in 12 patients). Theage of beginning of the disease was fluctuated in age from 16-19 years old till 60 above years old.4. By level of prevalence of this disease Mongolia now is belonging to countries of the world, which have lowprevalence of this disease (till 10 per 100.000 pop).
5.Prevalence of epilepsy and its specifics by age and sex among the rural population of Mongolia
Baasanjav D ; Erdenechimeg YA ; Oyungerel B ; Sarantsetseg TS ; Chimeglkham B ; Khandsuren B
Mongolian Medical Sciences 2010;153(3):13-17
Background: The data of prevalence of epilepsy in rural provinces among general population in Mongolia is rare. Goal:The study aimed to identify prevalence rate of epilepsy and its characteristics by age and sex among the population in eight provinces (Bayan-Ulgii, Bayankhongor, Gobi-Altai, Zavkhan, Uvurkhangai, Dundgobi, Orkhon and Hentii) of Mongolia.Material and Мethod: This study in the listed aimag populations was carried out by retrospective application and using a questionnaire developed according to a methodology approved by the Academic Council of the Medical Science Institute. For verification of the epilepsy diagnosis, the study based on neurologist examination and EEG. In some suspect cases we used neuroradiological tests including СT and MRI. The diagnosed patients were registered using a special form. The study involved diagnostic examinations of 627762 (306482 males; 321280 females) persons that had at least two unprovoked seizures in their lives. For each case of positive diagnosis we calculated the prevalence rate per 1,000 population in each category of extended age groups (1-12 months, 1-2, 3-4, 5-6, 7-8, 9-10, 11-12, 13-15, 16-17, 18-22, 23-27, 28-32, 33-37, 38-42, 43-47, 48-52, 53-59, and above 60) and by sex.Result: There were 1407 cases (785 males; 622 females) of diagnosed epilepsy among the studied population. The cumulative prevalence rate for all aimags was studied 2,24 (males- 2,56; females-1,93) per 1,000 population. The relatively high prevalence rates per 1,000 population were observed in Gobi-Altai (5,14), Dundgobi (3,31), and Orkhon (2,48) whereas the lowest rate was in Bayankhongor (1, 38). A differential look by sex reveals a high sex gap 6,20 for males and 4,12 for females in Gobi-Altai while Dundgobi (males- 3,84; females- 2,80), Orkhon (males-2,91; females-2,08); Uvurkhangai (males -2,20; females -1,73) show little difference by sex (P>0,05).As for the differences by the detailed age groups, all aimag data shows that prevalence for males ranges between 0,14(1- 12 months) and 5,17 (48-52) and for females between 0,24 (above 60) and 3,82 (38-42). The highest prevalence rate among male population was observed in 48-52 age group, 6,21/1000; followed by age groups 33-37 (2,93/1000); 53-59 (2,84/1000); 38-42 (2,81/1000); and 18-22 (2,38/1000). The highest prevalence rate among female population was observed in 43-47 age group 5,49/1000 followed by 38-42 (5,48/1000); 33-37 (4,0/1000); 53-59 (3,35/1000).Epilepsy prevalence in age groups younger than 11-12 tends to fall for both male and female population. Gender difference in prevalence is that males tend to have higher rates 2,56 than females 1,93 ( P<0,05).Conclusion:1. The general epilepsy prevalence among some rural populations in Mongolia is 2,24 (M -2,56; F-1,93) per 1,000 population.2. The cumulative by all studied aimags data reveal relatively high prevalence rate in age groups of 18-59. This level might be related to men’s vulnerability to traumas and factors of vascular origins while in women it might relate to their physiological transformations of pregnancy delivery and menopause.3. Epilepsy prevalence in age groups under 12 years old tends to fall for both male and female population which might be related to the low level of examination and diagnosis of these diseases among children.4. Compared to some foreign scholars’ data, Mongolia’s epilepsy prevalence rate does not qualify it among the high rate countries.
6.Epidemiology of neurohereditary diseases in the population of some provinces (aimags) existence in south and central part of Mongolia
Baasanjav D ; Erdenechimeg YA ; Chimeglkham B ; Sarantsetseg T ; Oyungerel B ; Bolormaa D
Mongolian Medical Sciences 2014;168(2):12-17
BACKGROUND:Our previous study has shown that the prevalence and structure of the neurohereditary diseaseswere different by provinces and some form of these diseases as “indigenous” in some isolatedpopulation. There are some scientific results of our researches–genetics about consanguineous,which is more potential factor of community is some area of Mongolia. All these circumstance isgiving to carry out this study.MATERIALS AND METHODS:We used descriptive epidemiological method for revealing hereditary neurological diseases in thepopulation of 6 provinces (aimags) of Mongolia: Dornogobi (Easth-gobi), Sukhbaatar, Gobisumber,Central aimag, Bulgan, and Darkhan-Uul. Total population of these provinces is 363072. Thenumber of population in 6 provinces was fluctuated in the range from 15.000 (Govisumber) to 88.875(Darkhan-Uul). Prevalence was accounted for 100.000 populations.RESULTS:The prevalence of neurohereditary diseases makes up 17.08 cases per 100.000 populations amongthese 6 provinces. 79% of these are hereditary neuromuscular diseases i.e 49 patients from 29families. Myotonic dystrophia and genetic neuropathies Charcot-Marie-Tooth have comparativehigh prevalence over test forms of disease.The high rate neurohereditary diseases was established in the population of Bulgan (35.80•10-5),Sukhbaatar (31.17•10-5), and Dornogobi (21.33•10-5) provinces. Their prevalence’s prevailed in the7-10 times over rates Darkhan-Uul, 3-5 times over rates of Gobisumber aimags.No neuromuscular forms of neurohereditary diseases i.e spastic paraplegia (11.3%) andspinocerebeller ataxia (9.68%) accounts for 21% among all forms of neurohereditary diseases.The prevalence of neuromuscular diseases in the population of these six provinces is two times highthen the average rate of the population of Russia (1980 years). First reason is may be associatedwith high predisposition of based on consanguineous through reproductive way in some of theseprovinces of Mongolia.
7.Epidemiology of neurohereditary diseases in the population of some provinces (aimags) existence in south and central part of Mongolia
Baasanjav D ; Erdenechimeg YA ; Chimeglkham B ; Sarantsetseg T ; Oyungerel B ; Bolormaa D
Mongolian Medical Sciences 2013;166(4):15-20
Background: Our previous study has shown that the prevalence and structure of the neurohereditary diseases were different by provinces and some form of these diseases as “indigenous” in some isolated population. There are some scientific results of our researches–genetics about consanguineous, which is more potential factor of community is some area of Mongolia. All these circumstance is giving to carry out this study.Materials and Methods: We used descriptive epidemiological method for revealing hereditary neurological diseases in the population of 6 provinces (aimags) of Mongolia: Dornogobi (Easthgobi), Sukhbaatar, Gobisumber, Central aimag, Bulgan, and Darkhan-Uul. Total population of these provinces is 363072. The number of population in 6 provinces was fluctuated in the range from 15.000 (Govisumber) to 88.875 (Darkhan-Uul). Prevalence was accounted for 100.000 populations.Results: The prevalence of neurohereditary diseases makes up 17.08 cases per 100.000 populations among these 6 provinces. 79% of these are hereditary neuromuscular diseases i.e. 49 patients from 29 families. Miltonic dystrophia and genetic neuropathies Charcot-Marie-Tooth have comparative high prevalence over test forms of disease.The high rate neurohereditary diseases was established in the population of Bulgan (35.80•10-5), Sukhbaatar (31.17•10-5), and Dornogobi (21.33•10-5) provinces. Their prevalence’s prevailed in the 7-10 times over rates Darkhan-Uul, 3-5 times over rates of Gobisumber aimags. No neuromuscular forms of neurohereditary diseases i.e spastic paraplegia (11.3%) and spinocerebeller ataxia (9.68%) accounts for 21% among all forms of neurohereditary diseases. The prevalence of neuromuscular diseases in the population of these six provinces is two times high then the average rate of the population of Russia (1980 years). First reason is may be associated with high predisposition of based on consanguineous through reproductive way in some of these provinces of Mongolia.
8.Mode of energy and metabolism which related to three state line systems of membrane-redoxy potentials and rlung, mkris, badgan symbolic coded
Narantsetseg B ; Narantsetseg J, Sarantsetseg B ; Khishigjargal S ; Ambaga M
Mongolian Medical Sciences 2013;166(4):57-62
Background. This study is to determine mode of metabolism on triple collaboration bridges of traditional medicine, modern medicine and NCM.Goal. To determine membrane redoxy potentials three line involves important regulation factors on mode of metabolism which relationship connected with rlung, mkris, and badgan symbolic code.Materials and Methods. Only 81 healthy individuals were involved in the study. Proton leak was determined by quantity rate of MDA in cell membrane and membrane resistance, proton conductance was determined by serum and urine oxidase activity.Results. The table 1 shows quantity rate of membrane resistance was decreased 1.08-1.52 fold, HDL content was decreased, and however LDL was increased. This result is to manifest low proton leak which means this type is likely belonged to badgan symbolic code with qualities cold fatty, earth, water. The table 2 shows serum and urine oxidize activity 2.22-6.1 fold was increased, HDL content was increased; UCP-3 gene activity relatively was increased. This result is to manifest highproton conductance which means this type is likely belonged to mkris symbolic code with qualities hot fatty, fire.Conclusions:1. Individuals with high proton leak and slow proton conductance had serum and urine oxidize activity were weak, therefore there are visceral and subcutaneous fat were low.2. Individuals with medium proton leak and high proton conductance had serum and urine oxidize activity were high, therefore there are visceral was low and subcutaneous fat was high.3. Individuals with weak proton leak and medium proton conductance had serum and urine oxidize activity were medium, therefore there are visceral was high and subcutaneous fat was low.
9.The inhibitory effects of rotenone, 2, 4-dinitrophenol, oligomycin on the electron proton flow through “The membrane redox potential three state line”
Delgermaa E ; Narantsetseg J ; Ambaga M ; Sarantsetseg B ; Tumen-Olzii A
Mongolian Medical Sciences 2014;170(4):78-83
Rotenone is a specific inhibitor of the NADH dehydrogenase complex. In mitochondria, rotenone inhibitsthe oxidation of NADH to NAD, thereby blocking the oxidation of NAD and the substrates such asglutamate, alpha-ketoglutarate, and pyruvate. Rotenone also inhibits the mitochondrial respiratory chainbetween diphosphopyridine nucleotide and flavine.2, 4-Dinitrophenol – (DNP) is lipophilic weak acids that pick up a proton, transport across the mitochondrialinner membrane into the matrix, deprotonate, then exit as anions before repeating the catalytic cycle,and dissipating the proton gradient. In this situation, electrons continue to pass through the electrontransport system, reduce oxygen to water and metabolic rate, heat are increased, but ATP is lesssynthesized in this process.The macrolide antibiotic - oligomycin binds to the surface of the c8-10 ring of the Fo domain of ATPsynthase, making contact with two neighboring molecules and blocking proton flow, which explains theinhibitory effect on ATP synthesis. Intraperitoneal injection of oligomycin into the rat (0.5 mg per kg)reduces the oxygen consumption by about 50%; decreases ATP production by the aerobic pathway andincreases formation of lactate in blood serum. These changes may cause a decelerated metabolism andan increased formation of free radicals or ROS in membranes.
10. Histocompatibility testing for kidney graft survival
Sarantsetseg J ; Naranmandakh G ; Bolortuya KH ; Oyungerel TS ; Batbaatar G ; Munkhbat B
Health Laboratory 2015;4(1):23-28
Background:Kidney transplantation has being performed in Mongolia since 2006. However there is currently no published data available on long-term graft and patient survival.Objective:Our aim was to assess the long-term graft and patient survival rate correlation with HLA-A-B-DR matching. Material and Methods:We retrospectively analyzed data from 70 adult kidney transplants performed at our hospital from August 2006 through January 2014. The data was retrospectively collected from patient fles, including characteristics of the recipient and donor, post transplant features and HLA-A-B-DR DNA based typing results. The KaplanMeier method was used to analyze graft and patient survival.Results:The mean patient follow-up period after kidney transplantation was 39,6±25.9 months, and the mean kidney graft follow-up period was 36.6±23.7 months for 70 cases. Overall graft and patient survivals were 52 (74.3%) and 60 (85.7%) respectively in 70 cases. Five-year graft and patient survivals were 23 (67.6%) and 29 (85.3%) respectively in 34 cases. The group with four to six mismatched were found to have a signifcantly lower 3 and 5-year graft and patient survival (71%; 35%); (80%; 40%) compared to 0 to 1 mismatched group (100%) (p=.030; p=.015). Furthermore we analyzed the association of HLA matching, immunosuppressive therapy and long-term graft survival. We selected CNI mono-therapy group for long-term survival analysis and observed a similar pattern. In mono-therapy group, the group with four to six mismatched were found to have a significantly lower 3 and 5-year graft and patient survival (75%; 30%); (65%; 30%) compared to 0 to 1 mismatched group (100%) (p=.037; p=.001).Conclusion:The results showed that graft and patient survival rates were lower compared with results from established centers. Statistically highly signifcant effect of HLA matching on kidney graft and patient survival rates was found in our analysis. Five years after transplantation the graft survival rate of frst adult kidney transplant with 4-6MM was 65-70% lower than that of grafts with 0-1MM. Longitudinal cohort study needed in the future to exhibit an improved transplantation outcome.